Does anyone have a negative opinion of the Frazier Water Protocol in Skilled Nursing Facilities? - AgingCare.com

Does anyone have a negative opinion of the Frazier Water Protocol in Skilled Nursing Facilities?

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I work for a nursing home corporation. I deal with patients with dysphasia every day. The problem with thicken liquids is that most residents don't like the taste because of the thickener but most importantly it does not quiche their thirst. Most patients or residents put on thicken liquids are at risk for dehydration, UTI's, constipation, lethargy, and other things that diminish their quality of life. All Speech Therapist do a complete evaluation on patents for risk of aspiration before they recommended the Frazier Free Water Protocol. The bottom line is that good hydration promotes a thriving life but it is proven that most on thickened liquids do not like the thickens and therefore do not get good hydration. basically the patients needs to have thicken liquids with each meal but between meals they can drink water with out food and they will have much better hydration and a better quality of life. The key here is no food when drinking reg water. If that is monitored and implemented the resident or patient will have a better quality of life.
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I once tried thickened red wine with my dad - he didn't think too much of the quality of the wine and I thought it was just OK - he was more of a connoisseur than me - but the thickener was not to blame. He unfortunately got a headache from the wine too...and before, he had never even had that problem. I started having that in the last few years myself, I did not used to react to those food s they say can trigger headaches. Un. Fair. IMHO.

But seriously, some people who hate one thickener like the other one (the tow main ones are Simply Thick and Thick-It, more people like the former, and there is a pre-thickened lemon flavored water available that is very thoroughly blended that some people like who hate everything else. I tell people to stir, let sit, stir a second time to get it well mixed. Also, picking things that are "supposed" to be thick, like using cold chocolate milk and having it be thick like a stiff milkshake might work.
You can get a fair amount of fluids from puree and pudding type foods too but probably not enough unless you do at least some nectar or honey thick liquids.

I think my Dad's tolerating the thick liquids helped keep him out of the hospital; he only got pneumonia if he had vomiting. He had some kind of frontotemporal dementia and Parkinson features were there but maybe not as prominent as it usually is for true Lewy body dementia. I hope you can find some things that Dad likes!
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Frankly, I can't imagine my husband enjoying his daily beer or wine thickened, whether he is also allowed plain water or not. We tried this diet several years ago. He gave it a good effort for a few months, but became more and more depressed until he finally said he'd rather take his risks with real food, even if it shortened his life. (He has Lewy Body Dementia.) He had the swallow test again because of increasing coughing while eating (but also while not eating ... hmmm). I went into it knowing that we might or might not follow all the recommendations but hoped it would be worthwhile even if we learned only a few tips the reduce risk. It is strictly a quality of life issue fo us. He is not going to recover from his disease. Being in the hospital with pneumonia is not exactly a high quality experience. Dreading every mealtime isn't high quality, either. We'll probably settle somewhere between following the diet strictly and ignoring it completely. We will try the thickened liquids. I know last time he hated thickened tea. Who knows? Maybe he'll enjoy thickened beer. :)
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I work at a rehab hospital and the speech therapists here are leery of it, but we are working with people who are recovering from acute illnesses and injuries, and in theory it might not be such a good thing to desenstize the airway if they get small amounts of water in it ftom this. But, I can reassure you that it does not hurt the lungs and results in better hydration. I've done it with some patients both in and outpatient and had it work well so far without exception. They officially put my dad on it, but he had zero problem with thickened liquids and didn't like plain water that well either so he didn't really use it that much. The main features of the protocol, either straight or modified, is the use of plain water ad lib, but only apart form meal times and after excellent oral hygeine has been done.

Thickened coffees and fruit juices are really good BTW - try some of the thickened stuff yourself, you may feel reassured that its not really totally unpalatable. Some people do just hate it though.
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Since I don't have anyone else to answer to, I'm going to try it at home.

I can well believe that anyone on a strict thickened liquid diet could easily become dehydrated due to lack of interest in drinking. The pathologist explained that plain water can be absorbed by the lungs, so it is not as risky as other liquids if it is aspirated. Makes sense to me, so I'll try it and watch the results.
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I have no hands on experience with it, all I know is that it may be a way for those with swallowing problems to take plain water to provide extra means of hydration and enjoyment. I don't know of many long term facilities willing to take the legal risk of having their staff give water to patients with swallowing deficits.
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The speech pathologist is recommending thickened liquids for my husband (we haven't decided if we'll follow that or not) but allowed the exception of plain water -- no lemon slice, no shot of orange juice, just palin water -- unthickened. She did not use the term Frazier water protocol, but that is it's chief feature, isn't it?
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I have no experience with it at all, but I looked it up just now and it sounds interesting. My husband is having a swallow test next week and I will discuss this with the therapist, depending on what she finds and recommends.

What is your experience with it.
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